Provider Demographics
NPI:1649644402
Name:SOLER, CARLOS
Entity type:Individual
Prefix:
First Name:CARLOS
Middle Name:
Last Name:SOLER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3019 MESA VERDE DR
Mailing Address - Street 2:APT. 3105
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-4387
Mailing Address - Country:US
Mailing Address - Phone:787-549-3032
Mailing Address - Fax:
Practice Address - Street 1:3019 MESA VERDE DR
Practice Address - Street 2:APT. 3105
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-4387
Practice Address - Country:US
Practice Address - Phone:787-549-3032
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-17
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLS460-101-68-041-0171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator